Abstract
Aims: Following hip fracture, a delay to surgery of greater than 24 hours is associated with a higher morbidity and mortality. In our unit, one of the common perceived delays is patients admitted on warfarin. The elective perioperative management of patients on warfarin is well documented. We aimed to define the incidence and delay of patients admitted with hip fractures on warfarin, and how its reversal was managed. Methods: Data was collected prospectively from 14 hospitals who contribute to the Scottish Hip Fracture Database. In addition to the data recorded on the Standardised Audit of Hip fractures in Europe form (SAHFE), specific questions relating to warfarin and its reversal were asked. Results: During 1.8.01–31.12.01, 1641 patients were admitted with a hip fracture, 42 patients (2.6%) were taking warfarin with the commonest indication being atrial fibrillation (40.5%). Mean INR on admission was 2.83 (range 1.2–8.2), and at surgery was 1.43 (range 1.0–2.0). Active reversal occurred in 19 patients. A delay to theatre of > 48 hours occurred in 72.7% of the warfarin group versus 19.0% in the non-warfarin group. There were wound complications in 5 patients taking warfarin. Conclusions: The number of patients admitted on warfarin was lower than we had anticipated. Delay to theatre was significantly higher in the warfarin group. The approach to the perioperative management of patients taking warfarin was varied.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
